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Study about Vaccination of Patients Diagnosed by Antimeasles Antibody in Measles Out break between 2000 and 2001 (2000~2001년 홍역 유행시 홍역 항체 유무로 진단된 환아의 홍역백신 접종 여부에 관한 연구)

  • Kang, Kye Wool;Yoon, Hwa Jun;Park, Seok Won;Kim, Hwang Min;Kim, Jong Soo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.67-73
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    • 2002
  • Purpose : Despite of the appropriate measles vaccination programs, epidemics occur every 2~3 years and especially occurred in large group in late of 2000 and early of 2001. To evaluate the effect of the vaccination, needs for revaccination and to determine the optimal age for revaccination, we examined measles specific IgG and IgM in mealses patients and investigated different antibody appearance according to vaccination history. Methods : Anti-measles antibodies were checked in sera of 201 patients(male : 117, female : 84) that are responsible for Criteria for Disease Control among 298 patients that are suspicious of measles including inpatients and outpatients in Wonju Christian Hospital from June in 2000 to June in 2001. They were checked by immunofluorescent assay. Then we classified them according to sex, month, distribution of age due to vaccination and appearance of measles antibody. Results : The ratio of male and female was 1.4 : 1. The maximum incidence was 38 cases(18.9%) in May in 2001. Incidence was increased from November in 2000 to January in 2001 and decreased in February and March in 2001. Thereafter it was increased from April in 2001 again and decreased from June. There were 93 cases(46.3%) in vaccinated group and 108 cases(53.7%) in unvaccinated group. In the distribution according to age in vaccinated group, there were 54 cases(58.1%) in more than 10 years old, 15 cases(16.0%) between 7 and 10 years old, 12 cases(12.9%) between 15 months and 3 years old, 6 cases (6.5%) between 4 and 6 years old and 6 cases(6.5%) between 6 months and 14 months old. In the distribution according to age in unvaccinated group, there were 88 cases(81.5%) between 6 months and 14 months old, 9 cases(8.3%) between 15 months and 3 years old, 7 cases(6.5%) less than 6 months old, 3 cases(2.8%) more than 10 years old and 1 case(0.9%) between 7 and 10 years old. In the distribution of measles specific IgG and IgM, 78 cas (87.6%) were IgG(+), IgM(+) and 11 cases(12.4%) are IgG(+), IgM(-) in vaccinated group. In unvaccinated group, there were 69 cases(63.9%) of IgG(+), IgM(+) and 39 cases (36.1%) of IgG(-), IgM(+). Con c lu s i on s : We thought that measles incidence was peaked between 6 months and 14 months old in unvaccinated group because of maximum decrement of transplacental matenal antibody and was peaked in more than 10 years old in vaccinated group because of maximum decrement of measles specific IgG. We think that measles revaccination as well as vaccination and especially optimal age for revaccination is very important to prevent measles successfully.

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Fish Stock Assessment by Hydroacoustic Methods and its Applications - I - Estimation of Fish School Target Strength - (음향에 의한 어족생물의 자원조사 연구 - I - 어군반사강도의 추정 -)

  • Lee, Dae-Jae;Shin, Hyeong-Il;Shin, Hyong-Ho
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.31 no.2
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    • pp.142-152
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    • 1995
  • The combined bottom trawl and hydroacoustic survey was conducted by using the training ship Oshoro Maru belong to Hokkaido University in November 1989-1992 and the training ship Nagasaki Maru belong to Nagasaki University in April 1994 in the East China Sea, respectively. The aim of the investigations was to collect the target strength data of fish school in relation to the biomass estimation of fish in the survey area. The hydroacoustic survey was performed by using the scientific echo sounder system operating at three frequencies of 25, 50 and 100kHz with a microcomputer-based echo integrator. Fish samples were collected by bottom trawling and during the trawl surveys, the openings of otter board and net mouth were measured. The target strength of fish school was estimated from the relationship between the volume back scattering strength for the depth strata of bottom trawling and the weight per unit volume of trawl catches. A portion of the trawl catches preserved in frozon condition on board, the target strength measurements for the defrosted samples of ten species were conducted in the laboratory tank, and the relationship between target strength and fish weight was examined. In order to investigate the effect of swimbladder on target strength, the volume of the swimbladder of white croaker, Argyrosomus argentatus, sampled by bottom trawling was measured by directly removing the gas in the swimbladder with a syringe on board. The results obtained can be summarized as follows: 1.The relationship between the mean volume back scattering strength (, dB) for the depth strata of trawl hauls and the weight(C, $kg/\textrm{m}^3$) per unit volume of trawl catches were expressed by the following equations : 25kHz : = - 29.8+10Log(C) 50kHz : = - 32.4+10Log(C) 100kHz : = - 31.7+10Log(C) The mean target strength estimates for three frequencies of 25, 50 and 100 kHz derived from these equations were -29.8dB/kg, -32.4dB/kg and -31.7dB/kg, respectively. 2. The relationship between target strength and body weight for the fish samples of ten species collected by trawl surveys were expressed by the following equations : 25kHz : TS = - 34.0+10Log($W^{\frac{2}{3}}$) 100kHz : TS = - 37.8+10Log($W^{\frac{2}{3}}$) The mean target strength estimates for two frequencies of 25 and 100 kHz derived from these equations were -34.0dB/kg, -37.8dB/kg, respectively. 3. The representative target strength values for demersal fish populations of the East China Sea at two frequencies of 25 and 100 kHz were estimated to be -31.4dB/kg, -33.8dB/kg, respectively. 4. The ratio of the equivalent radius of swimbladder to body length of white croaker was 0.089 and the volume of swimbladder was estimated to be approximately 10% of total body volume.

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Diagnostic Values of Abdominal Ultrasonography in Patients with Fever and Abdominal Symptoms (발열과 복부 증상을 주소로 하는 환아에서 복부 초음파 검사의 진단적 의의에 관한 연구)

  • Lee, Mi-Kyung;Im, Chang-Sung;Ahn, Sun-Mi;Kim, Chang-Hi;Lee, Dong-Jin;Kwan, Joong-Hyuck;Park, Yong-Hoon
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.191-202
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    • 1995
  • Purpose: Acute febrile illness in children frequently accompanies with abdominal symptoms such as vomiting, diarrhea, and abdominal pain, even if its etiology is not occured from the gastrointestinal tract. If the etiology of fever was unknown and the fever was accompanied with abdominal symptoms, we should be concerned about whether the etiology of fever was originated from the gastrointestinal tract or interpretated from the abnormality in the gastrointestinal tract. This study was performed to evaluate the diagnostic value of abdominal ultrasonography in patients with fever and abdominal symptoms. Methods: We reviewed retrospectively the medical records of abdominal ultrasonographic (US) findings of 60 cases of acute febrile illness with abdominal symptoms at department of Pediatrics, Ulsan Dongang General Hospital during the period from January 1994 to June 1995. Results: The abnormal abdominal US findings obtained were as follows. 1) The abnormal US findings were seen in 56 cases (93.3%). 2) The most common abnormal US finding was the enlarged mesenteric lymph nodes in 52 cases (86.7%) 3) The enlarged mesenteric lymph nodes with or without intra-abdominal fluid were seen in 30 cases (50.0%) of a wide variety of illnesses, so their diagnostic values were absent. 4) The enlarged mesenteric lymph nodes and splenomegaly with or without ileocecitis were seen in 7 cases. Among them, 4 cases (6.7%) were confirmed as typhoid fever. 5) The US findings in 6 cases of typhoid fever were the enlarged mesenteric lymph nodes in all cases (100%), splenomegaly in 4 cases (66.7%), ileocecitis in 1 case (16.7%), enlarged mesenteric lymph nodes and splenomegaly in 4 cases (66.7%), enlarged mesenteric lymph nodes, splenomegaly and ileocecitis in 1 cases (16.7%). 6) The enlarged mesenteric lymph nodes and the abnormalities around the appendix were seen in 7 cases (11.7%), which were confirmed as appendicitis all. 7) The thickening of wall in urinary bladder was seen in 2 cases (3.3%) of acute cystitis and acute hemorrhagic cystitis. 8) The subtle thickening of wall in colon was seen in 1 cases (1.7%) of shigellosis. Conclusions: The enlarged mesenteric lymph nodes, splenomegaly and ileocolitis on the abdominal ultrasonography in patients with fever and abdominal symptoms aree suggestive findings of typhoid fever. The enlarged mesenteric lymph nodes and the abnormalities around the appendix on abdominal ultrasonography make the rapid diagnosis of acute appendicitis and its complications, when physical examination is difficult in small children and diagnosis of their illnesses is obscure in patients with fever and abdominal pain.

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Relationship between Insomnia and Depression in Type 2 Diabetics (2형 당뇨병 환자에서 불면증과 우울 증상의 관련성)

  • Lee, Jin Hwan;Cheon, Jin Sook;Choi, Young Sik;Kim, Ho Chan;Oh, Byoung Hoon
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.50-59
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    • 2019
  • Objectives : Many of the patients with type 2 diabetes are associated with sleep problems, and the rate of insomnia is known to be higher in the general population. The aims of this study were to know the frequency and clnical characteristics of insomnia, and related variables to insomnia in patients diagnosed with type 2 diabetes. Methods : For 99 patients from 18 to 80 years of age (65 males and 34 females) with type 2 diabetes, interviews were performed. Total sleep time and sleep latency was evaluated. Insomnia was evaluated using the Korean Version of the Insomnia Severity Index (ISI-K). Severity of depressive symptoms were evaluted using the Korean version of the Hamilton Depression Scale (K-HDRM). According to the cutoff score of 15.5 on the ISI-K, subjects were divided into the group of type 2 diabetics with insomnia (N=34) and those without insomnia (N=65) at first, and then statistically analyzed. Results : TInsomnia could be found in 34.34% of type 2 diabetics. Type 2 diabetics with insomnia had significantly more single or divorced (respectively 11.8%, p<0.05), higher total scores of the K-HDRS ($11.76{\pm}5.52$, p<0.001), shorter total sleep time ($5.35{\pm}2.00hours$, p<0.001), and longer sleep latency ($50.29{\pm}33.80minutes$, p<0.001). The all item scores of the ISI-K in type 2 diabetics with insomnia were significantly higher than those in type 2 diabetics without insomnia, that is, total ($18.38{\pm}2.69$), A1 (Initial insomnia) ($2.97{\pm}0.76$), A2 (Middle insomnia) ($3.06{\pm}0.69$), A3 (Terminal insomnia) ($2.76{\pm}0.61$), B (Satisfaction) ($3.18{\pm}0.72$), C (Interference) ($2.09{\pm}0.97$), D (Noticeability) ($2.12{\pm}1.09$) and E (Distress) ($2.21{\pm}0.81$) (respectively p<0.001). Variables associated with insomnia in type 2 diabetics were as following. Age had significant negative correlation with A3 items of the ISI-K (${\beta}=-0.241$, p<0.05). Total scores of the K-HDRS had significant positive correlation, while total sleep time had significant negative correlation with all items of the ISI-K (respectively p<0.05). Sleep latency had significant positive correlation with total,, A1, B and E item scores of the ISI-K (respectively p<0.05). Conclusions : Insomnia was found in about 1/3 of type 2 diabetics. According to the presence of insomnia, clinical characteristics including sleep quality as well as quantity seemed to be different. Because depression seemed to be correlated with insomnia, clinicians should pay attention to early detection and intervention of depression among type 2 diabetics.

A Study on the Psychosocial Characteristics and Quality of Life in Functional Gastrointestinal Disorders (기능성위장질환 환자들의 정신사회적 특성 및 삶의 질의 관계에 관한 연구)

  • Kim, So-Won;Jang, Seung-Ho;Ryu, Han-Seung;Choi, Suck-Chei;Rho, Seung-Ho;Lee, Sang-Yeol
    • Korean Journal of Psychosomatic Medicine
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    • v.27 no.1
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    • pp.25-34
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    • 2019
  • Objectives : This study aimed to compare the psychosocial characteristics among patients with functional gastrointestinal disorder (FGID), adults with functional gastrointestinal symptoms, and normal control group and investigate factors related to quality of life (QoL) of FGID patients. Methods : 65 patients diagnosed with FGID were selected. 79 adults were selected as normal control group based on the Rome III diagnostic criteria, and 88 adults who showed functional gastrointestinal symptoms were selected as "FGID positive group". Demographic factors were investigated. Psychosocial factors were evaluated using the Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multi-dimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale and WHO Quality of Life Assessment Instrument Brief Form. A one-way ANOVA was used to compare differences among groups. Pearson correlation test was used to analyze correlations between QoL and psychosocial factors in patients with FGID. Results : There were group differences in the education level. Depression (F=29.012, p<0.001), anxiety (F=27.954, p<0.001) and Childhood trauma (F=7.748, p<0.001) were significantly higher in FGID patient group than in both FGID-positive and normal control group. Social support (F=5,123, p<0.001), Resilience (F=9.623, p<0.001) and QoL (F=35.991, p<0.001) were significantly lower in the FGID patient group than in others. QoL of FGID patients showed a positive correlation with resilience (r=0.475, p<0.01), and showed a negative correlation with depression (r=-0.641, p<0.01), anxiety (r=-0.641, p<0.01), and childhood trauma (r=-0.278, p<0.05). Conclusions : FGID patients have distinctive psychosocial factors compared to the both FGID-positive and normal control group. Therefore, the active interventions for psychosocial factors are required in the treatment of patients with FGID.

A Study of Dohang-Ri wooden coffin and Anya-Kuk (도항리목관묘(道項里木棺墓) 안사국(安邪國))

  • Lee, Ju-Huen
    • Korean Journal of Heritage: History & Science
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    • v.37
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    • pp.5-37
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    • 2004
  • A wooden coffin has been given academic attention in Kaya(伽倻), due to the place the stage of Samhan society appropriately in the development of ancient korea history. Special attention must be paid on Dohang-Ri(道項里) woden coffin, since it is expected to explain the origin of Arakaya(阿羅伽倻) in the region of southen korea peninsula. Dohang-Ri wooden coffin is become generally knowen two types, and complete its unique feature in Chin-Han(辰韓) and Byun-Han(弁韓). Recently the fact that Dohang-Ri wooden coffin is discovered only in the king tombs of Chang Won Daho-Ri(昌原茶戶里) and it is remarkable of political connection between Kuya-Kuk (狗邪國) and Anya-Kuk(安邪國). Various ironware unearth of Dohang-Ri has seen similar to that from Daho-Ri, but it has not bronze mirror be maid Chines, symbol with dignity of social position in the ruling ciass. It seems that political unit of Daho-Ri is advanced sociaity and central force than Dohang-Ri in the Byun-Han. The later of two century, I have a think about wooden coffin changes the wooden chamble of Dohang-Ri and Daho-Ri that it go out of sight at AD.2 century. Becouse of possitive achaelogical sites has not confirm, it request radical interpretaion. I inference to accordingly to the it appearance connected of the wars between the eight country of southen regins in korea peninsula at the first half of AD.3 cencury. Exactly, the politial units of Dohang-Ri and Daho-Ri has concentration of trade in Racdong river(洛東江) and Nam river(南江) water system and that give form to coexistence system of economic and political mutuality.

Documentation of Intangible Cultural Heritage Using Motion Capture Technology Focusing on the documentation of Seungmu, Salpuri and Taepyeongmu (부록 3. 모션캡쳐를 이용한 무형문화재의 기록작성 - 국가지정 중요무형문화재 승무·살풀이·태평무를 중심으로 -)

  • Park, Weonmo;Go, Jungil;Kim, Yongsuk
    • Korean Journal of Heritage: History & Science
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    • v.39
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    • pp.351-378
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    • 2006
  • With the development of media, the methods for the documentation of intangible cultural heritage have been also developed and diversified. As well as the previous analogue ways of documentation, the have been recently applying new multi-media technologies focusing on digital pictures, sound sources, movies, etc. Among the new technologies, the documentation of intangible cultural heritage using the method of 'Motion Capture' has proved itself prominent especially in the fields that require three-dimensional documentation such as dances and performances. Motion Capture refers to the documentation technology which records the signals of the time varing positions derived from the sensors equipped on the surface of an object. It converts the signals from the sensors into digital data which can be plotted as points on the virtual coordinates of the computer and records the movement of the points during a certain period of time, as the object moves. It produces scientific data for the preservation of intangible cultural heritage, by displaying digital data which represents the virtual motion of a holder of an intangible cultural heritage. National Research Institute of Cultural Properties (NRICP) has been working on for the development of new documentation method for the Important Intangible Cultural Heritage designated by Korean government. This is to be done using 'motion capture' equipments which are also widely used for the computer graphics in movie or game industries. This project is designed to apply the motion capture technology for 3 years- from 2005 to 2007 - for 11 performances from 7 traditional dances of which body gestures have considerable values among the Important Intangible Cultural Heritage performances. This is to be supported by lottery funds. In 2005, the first year of the project, accumulated were data of single dances, such as Seungmu (monk's dance), Salpuri(a solo dance for spiritual cleansing dance), Taepyeongmu (dance of peace), which are relatively easy in terms of performing skills. In 2006, group dances, such as Jinju Geommu (Jinju sword dance), Seungjeonmu (dance for victory), Cheoyongmu (dance of Lord Cheoyong), etc., will be documented. In the last year of the project, 2007, education programme for comparative studies, analysis and transmission of intangible cultural heritage and three-dimensional contents for public service will be devised, based on the accumulated data, as well as the documentation of Hakyeonhwadae Habseolmu (crane dance combined with the lotus blossom dance). By describing the processes and results of motion capture documentation of Salpuri dance (Lee Mae-bang), Taepyeongmu (Kang seon-young) and Seungmu (Lee Mae-bang, Lee Ae-ju and Jung Jae-man) conducted in 2005, this report introduces a new approach for the documentation of intangible cultural heritage. During the first year of the project, two questions have been raised. First, how can we capture motions of a holder (dancer) without cutoffs during quite a long performance? After many times of tests, the motion capture system proved itself stable with continuous results. Second, how can we reproduce the accurate motion without the re-targeting process? The project re-created the most accurate motion of the dancer's gestures, applying the new technology to drew out the shape of the dancers's body digital data before the motion capture process for the first time in Korea. The accurate three-dimensional body models for four holders obtained by the body scanning enhanced the accuracy of the motion capture of the dance.

A Study on the Compositional Characteristics of Water Systems and Landscapes in Traditional Chinese Seowons (중국 전통서원의 수체계와 수경관의 구성적 특성)

  • MA, Shuxiao;RHO, Jaehyun
    • Korean Journal of Heritage: History & Science
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    • v.55 no.3
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    • pp.74-100
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    • 2022
  • The purpose of this study was to investigate the characteristics of Chinese seowons and to obtain data based on the characteristics of waterscapes unique to Korean seowons. The conclusion of this study from the results of investigation and analysis of the location, water system, and design characteristics of 10 representative traditional seowons in China including Yuelu Seowon(嶽麓書院) conducted based on literature research and field observation is as follows. The water system of Chinese seowons is dualized into an inner and an outer water system, and in general, two and a maximum of three water bodies are superimposed on the outside. The locations of seowons are classified into five types: Four double-sided round water type sites, three converted face water type sites, one three-sided round water type site, a four-sided round water type, and a waterproofing type(依山傍水型). Therefore, compared to the typical Korean seowon facing water in the front and a mountain in the back(背山面水型), the Chinese seowons showed a highly hydrophilic property. The water shapes of the external water system were meandering(46.0%), mooring(36.0%), and broad and irregular(9.0%). In addition, water conception(水態) were streams(31.8%), rivers(27.3%), springs(13.6%), falls(9.1%), lakes(4.5%) and ponds(4.5%), in that order. As for waterscapes of the water system inside the seowon, there were seven in Akrok Seowon and four in Mansong Seowon, indicating a comparatively higher number of waterscapes. Since the 27 detailed waterscapes in 10 seowons that were the subject of the study were classified into six types including ponds and half-moon ponds, they appeared to be more diverse than the Korean seowon. It is noteworthy that in the interior waterscape of the traditional Chinese seowon, the ritualistic order, where at least one half-moon pond or square pond(方池) was arranged, is well displayed. In particular, the half-moon pond(伴池), which is difficult to find in Korean seowon, was found to be a representative waterscape element, accounting for 42.8%. If the square pond of Nanxi Seowon based on Zhu Xi's poem 「Gwanseoyugam(觀書有感)」 is also treated as a square-shaped half-moon pond, the proportion of half-moon ponds in the waterscape will be as high as 50%. The pond shapes consisted of 28% square, 24% each for free curve and round shape, 20% for semi-moon shape, and 3.8% for mountain stream type. This seems to differ greatly from the square-shaped Korean seowon. On the other hand, there were a total of 10 types of structures related to the waterscape inside the Chinese seowon: 11(26.8%) pavilion and bridge sites, five gate room sites(牌坊: 16.5%), four gate and tower sites(樓, 1.4%), two Jae sites(齋, 6.2%), and one site each(3.1%) of Heon(軒), Sa(祠), Dae(臺), and Gak(閣). In particular, the pavilions inside seowon were classified into three types: landscape pavilion(景觀亭 27.2%), tombstone pavilion(碑亭, 18.2%), and banquet pavilion(宴集亭, 54.5%). In general, it was confirmed that the half-moon pond with a pedestal bridge, and the pavilion were the major components with a high degree of connection that dominate the waterscape inside the Chinese seowon.

The Difference in Chemokine Expression in Airway Epithelial Cells According to the Virulence of Tubercle Bacilli (결핵균 독성 여부에 따른 기도 상피세포의 Chemokine 발현에 관한 연구)

  • Kwon, O-Jung;Kim, Ho-Joong;Kim, Jung-Hee;Kim, Ho-Cheol;Suh, Gee-Young;Park, Jeong-Woong;Park, Sang-Joon;Chung, Man-Pyo;Choi, Dong-Chull;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.729-741
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    • 1997
  • Background : We have recently reported that airway epithelial cells can produce RANTES and IL-8 in response to the stimulation of tubercle bacilli suggesting a certain role of airway epithelial cells in the pathogenesis of pulmonary tuberculosis. The pathogenesis of tuberculosis is determined by several factors including phagocytosis, immunological response of host, and virulence of tubercle bacilli. Interestingly, there have been reports suggesting that difference in immunological response of host according to the virulence of tubercle bacilli may be related with the pathogenesis of tuberculosis. We, therefore, studied the expressions and productions of RANTES and IL-8 in airway epithelial cells in response to tubercle bacilli(H37Rv, virulent strain and H37Ra, avirulent strain), in order to elucidate the possible pathophysiology of pulmonary tuberculosis. Methods : Peripheral blood monocytes were isolated from normal volunteers. Peripheral blood monocytes (PBM) were stimulated with LPS($10{\mu}g/ml$), H37Rv, or H37Ra($5{\times}10^5$ bacilli/well) along with normal control for 24 hours. A549 cells were stimulated with supernatants of cultured PBM for 24 hours. ELISA kit was used for the measurement of $TNF{\alpha}$ and IL-$1{\beta}$ production in supernatants of cultured PBM and for the measurement of RANTES and IL-8 in supernatants of cultured A549 cells. Northern blot analysis was used for the measurement of RANTES and IL-8 mRNA expression in cultured A549 cells. Results : $TNF{\alpha}$ and IL-$1{\beta}$ productions were increased in cultured PBM stimulated with LPS or tubercle bacilli(H37Rv or H37Ra) compared with the control. There was, however, no difference in $TNF{\alpha}$ and IL-$1{\beta}$ production between cultured PBM stimulated with H37Rv and H37Ra. RANTES and IL-8 expressions and productions were also increased in cultured A549 cells stimulated with LPS or tubercle bacilli compared with the control. RANTES and IL-8 mRNA expressions were significantly increased in cultured A549 cells stimulated with H37Ra-conditioned media(CM) compared with A549 cells stimulated with H37Rv-CM (p<0.05). However, there was no difference in RANTES and IL-8 productions between A549 cells stimulated with H37Rv-CM and H37Ra-CM. Conclusion : Airway epithelial cells can produce the potent chemokines such as RANTES and IL-8, in response to the stimulation of tubercle bacilli. These results suggest that airway epithelial cells may play a certain role in the pathogenesis of pulmonary tuberculosis. However, the role of airway epithelial cells in the pathogenesis of tuberculosis according to the virulence of tubercle bacilli was not clear in this study.

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Clinical Application of Serum CEA, SCC, Cyfra21-1, and TPA in Lung Cancer (폐암환자에서 혈청 CEA, SCC, Cyfra21-1, TPA-M 측정의 의의)

  • Lee, Jun-Ho;Kim, Kyung-Chan;Lee, Sang-Jun;Lee, Jong-Kook;Jo, Sung-Jae;Kwon, Kun-Young;Han, Sung-Beom;Jeon, Young-June
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.785-795
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    • 1997
  • Background : Tumor markers have been used in diagnosis, predicting the extent of disease, monitoring recurrence after therapy and prediction of prognosis. But the utility of markers in lung cancer has been limited by low sensitivity and specificity. TPA-M is recently developed marker using combined monoclonal antibody of Cytokeratin 8, 18, and 19. This study was conducted to evaluate the efficacy of new tumor marker, TPA-M by comparing the estabilished markers SCC, CEA, Cyfra21-1 in lung cancer. Method : An immunoradiometric assay of serum CEA, sec, Cyfra21-1, and TPA-M was performed in 49 pathologically confirmed lung cancer patients who visited Keimyung University Hospital from April 1996 to August 1996, and 29 benign lung diseases. Commercially available kits, Ab bead CEA (Eiken) to CEA, SCC RIA BEAD (DAINABOT) to SCC, CA2H (TFB) to Cyfra2H. and TPA-M (DAIICHI) to TPA-M were used for this study. Results : The mean serum values of lung cancer group and control group were $10.05{\pm}38.39{\mu}/L$, $1.59{\pm}0.94{\mu}/L$ in CEA, $3.04{\pm}5.79{\mu}/L$, $1.58{\pm}2.85{\mu}/L$ in SCC, $8.27{\pm}11.96{\mu}/L$, $1.77{\pm}2.72{\mu}/L$ in Cyfra21-1, and $132.02{\pm}209.35\;U/L$, $45.86{\pm}75.86\;U/L$ in TPA-M respectively. Serum values of Cyfra21-1 and TPA-M in lung cancer group were higher than control group (p<0.05). Using cutoff value recommended by the manufactures, that is $2.5{\mu}/L$ in CEA, $3.0{\mu}/L$ in Cyfra21-1, 70.0 U/L in TPA-M, and $2.0{\mu}/L$ in SCC, sensitivity and specificity of lung cancer were 33.3%, 78.6% in CEA, 50.0%, 89.7% in Cyfra21-1, 52.3%, 89.7% in TPA-M, 23.8%, 89.3% in SCC. Sensitivity and specificity of nonsmall cell lung cancer were 36.1%, 78.1% in CEA, 50.1%, 89.7% in Cyfra21-1, 53.1%, 89.7% in TPA-M, 33.8%, 89.3% in SCC. Sensitivity and specificity of small cell lung cancer were 25.0%, 78.5% in CEA, 50.0%, 89.6% in Cyfra21-1, 50.0%, 89.6% in TPA-M, 0%, 89.2% in SCC. Cutoff value according to ROC(Receiver operating characteristics) curve was $1.25{\mu}/L$ in CEA, $1.5{\mu}/L$ in Cyfra2-1, 35 U/L in TPA-M, $0.6{\mu}/L$ in SCC. With this cutoff value, sensitivity, specificity, accuracy and kappa index of Cyfra21-1 and TPA-M were better than CEA and SCC. SCC only was related with statistic significance to TNM stages, dividing to operable stages(TNM stage I to IIIA) and inoperable stages (IIIB and IV) (p<0.05). But no tumor markers showed any correlation with significance with tumor size(p>0.05). Conclusion : Serum TPA-M and Cyfra21-1 shows higher sensitivity and specificity than CEA and SCC in overall lung cancer and nonsmall cell lung cancer those were confirmed pathologically. SCC has higher specificity in nonsmall cell lung cancer. And the level of serum sec are signiticantly related with TNM staging.

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